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100			_a Phillipo L Chalya _915821
222			_a Splenic injuries Aetiological spectrum Injury characteristics Treatment outcome Predictors of outcome Tanzania
245			_aSplenic injuries at Bugando Medical Centre in northwestern Tanzania: a tertiary hospital experience
260			_aMwanza, Tanzania: _bCatholic University of Health and Allied Sciences CUHAS - Bugando & _bBioMed Central _c23 January 2012
300			_a Pages 1-9
490			_vBMC Research notes Volume 5 Issue 1
520			_aAbstract: Background: Splenic injuries constitute a continuing diagnostic and therapeutic challenge to the trauma or general surgeons practicing in developing countries where sophisticated imaging facilities are either not available or exorbitantly expensive. The purpose of this review was to describe our own experience in the management of the splenic injuries outlining the aetiological spectrum, injury characteristics and treatment outcome of splenic injuries in our local environment and to identify predictors of outcome among these patients. Methods: A prospective descriptive study of splenic injury patients was carried out at Bugando Medical Centre in Northwestern Tanzania between March 2009 and February 2011. Statistical data analysis was done using SPSS software version 17.0. Results: A total of 118 patients were studied. The male to female ratio was 6.4:1. Their ages ranged from 8 to 74 years with a median age of 22 years. The modal age group was 21-30 years. The majority of patients (89.8%) had blunt trauma and road traffic accidents (63.6%) were the most frequent cause of injuries. Most patients sustained grade III (39.0%) and IV (38.1%) splenic injuries. Majority of patients (86.4%) were treated operatively with splenectomy (97.1%) being the most frequently performed procedure. Postoperative complications were recorded in 30.5% of cases. The overall length of hospital stay (LOS) ranged from 1 day to 120 days with a median of 18 days. Mortality rate was 19.5%. Patients who had severe trauma (Kampala Trauma Score II ≤ 6) and those with associated injuries stayed longer in the hospital (P < 0.001), whereas age of the patient, associated injuries, trauma scores (KTS II), grade of splenic injuries, admission systolic blood pressure ≤ 90 mmHg, estimated blood loss > 2000 mls, HIV infection with CD4 ≤ 200 cells/μl and presence of postoperative complications were significantly associated with mortality (P < 0.001). Conclusion: Trauma resulting from road traffic accidents (RTAs) remains the most common cause of splenic injuries in our setting. Most of the splenic injuries were Grade III & IV and splenectomy was performed in majority of the cases. Non-operative management can be adopted in patients with blunt isolated and low grade splenic injuries but operative management is still indispensable in this part of Tanzania. Urgent preventive measures targeting at reducing the occurrence of RTAs is necessary to reduce the incidence of splenic injuries in our centre.
700			_aJoseph B Mabula _922948
700			_aGeofrey Giiti _922597
700			_aAlphonce B Chandika _923222
700			_a Ramesh M Dass _923309
700			_aMabula D Mchembe _922908
700			_a Japhet M Gilyoma (RIP) _922889
856			_uhttps://doi.org/10.1186/1756-0500-5-59
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